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'''Abraham Leo Wolbarst''', M.D.{{MD}},({{LifeData|1872-|1952}}) a New York City physician, was solely responsible for the invention of the myth that [[circumcision]] rendered males immune to and [[penile cancercircumcised doctors| circumcised doctor]].<ref name="wolbarst1932">Wolbarst, AL. Circumcision and penile cancer. ''Lancet'' 1932; 150-3.</ref> Wolbarst wrote an article that was published in ''The Lancet'' in 1932, implicating human male smegma as carcinogenic.<ref name="wolbarst1932"/> Wolbarst's myth was based entirely on unverifiable anecdotes, ethnocentric stereotypes, a faulty understanding notorious promoter of human anatomy and physiology, a misunderstanding of the distinction between association and cause, and an unbridled missionary zeal, and it had absolutely no basis in valid scientific and epidemiological research.<ref name="fleiss1996">Fleiss PM, Hodges F. harmful non-therapeutic neonatal male [[http://www.cirp.org/library/disease/cancer/fleiss/ Neonatal circumcision does not protect against cancer]]. ''BMJ'' 1996;312(7033):779-80.</ref>

Wolbarst was directly responsible for its proliferation. All subsequent repetions of this myth are directly traceable to Wolbarst's article, though Wolbarst himself advocated universal neonatal ==Universal circumcision principally as a preventive for epilepsy, paralysis, and [[masturbation]]. Circumcision advocates such as Wolbarst do not seem to have promoted this myth because they have a genuine interest in reducing penile cancer; they used it instead as a scare tactic in the promotion of neonatal circumcision.<ref namesanitary measure=="fleiss1996" />

Holt (1913) reported in an article published in the ''Journal of the American Medical Association'' (JAMA) that tubercular ''mohelim'' were infecting baby boys with tuberculosis by the performance of ritual circumcision.<ref name="holt1913">{{REFjournal |last=Holt |first=L. Emmett |init=LE |author-link=L. Emmett Holt |etal=no |title=Tuberculosis acquired through ritual circumcision |journal=JAMA |date=1913-7-12 |volume=61 |issue=2 |pages=99-102 |url=http://www.cirp.org/library/complications/holt1/ |accessdate=2020-03-30}}</ref> Wolbarst was incensed by what he perceived as an attack on [[Brit Milah| ritual circumcision]], so he resolved to defend ritual circumcision by arguing that [[circumcision]] provided health benefits. Wolbarst's defense of circumcision was published in ''JAMA'' in 1914 and entitled "''Universal Circumcision as a Sanitary Measure''".<ref name="wolbarst1914">{{REFjournal |last=Wolbarst |first=Abraham L. |init=AL |author-link=Abraham L. Wolbarst |title=Universal Circumcision as a Sanitary Measure |journal=JAMA |date=1914-01-10 |volume=62 |issue=2 |pages=92-97 |url=https://jamanetwork.com/journals/jama/article-abstract/453164 |accessdate=2020-03-30}}</ref>  This was before the days of evidence-based medicine, when doctors relied on medical ''opinion'', instead of scientific ''evidence''. Wolbarst collected the ''opinions'' of several physicians and published those opinions as evidence for his argument that circumcision prevented diseases. Wolbarst argued that non-therapeutic neonatal circumcision prevented numerous diseases including venereal disease (now known as sexually transmitted disease). Skeldon (2008) commented:<blockquote>At first one might think that there was now a wave of medical evidence supporting thepractice of routine male circumcision, but a closer look shows that most of these claimswere observational and not evidence-based. For instance, in his article “Universalcircumcision as a sanitary measure,” the New York physician Abraham Leo Wolbarst(1872-1978) argues that circumcision prevents masturbation. During its publication, thiswas already a commonly held view and so was not generally questioned. But if oneconsiders the implications of this, it becomes apparent that to statistically prove such aclaim among young boys would be virtually impossible. This is why Wolbarst’s evidence consisted of what he called “authoritative observations” from other respectedpractitioners in the field.<ref name="skeldon2008">{{REFconference |last=Skeldon |first=Sean |author-link= |title=The Medicalization and Resultant Decline of Circumcision in Canada |trans-title= |language= |url=https://prism.ucalgary.ca/server/api/core/bitstreams/028cdb7b-3536-4b5b-921b-46ba3a2262ec/content |archived= |place=Calgary, AB |publisher=Health Sciences Centre |source= |date=2008-03 |datefrom=2008-03-07 |dateto=2008-03-08 |format=PDF |accessdate=2025-01-19}}</ref></blockquote> Wolbarst's article appeared on the eve of World War I. It apparently influenced American military commanders to order [[adult circumcision| circumcision]] of military personnel under their command to prevent venereal diseases and improve military readiness.<ref name="skeldon2008" /> No statistics exist to document how many men were [[circumcised]] because of Wolbarst's article. The adoption of circumcision as a prophylactic [[amputation]] by American military services falsely stigmatized the [[foreskin]] as being unhealthy. [[Robert S. Van Howe|Van Howe]] (1999) has exhaustively shown that circumcision does not protect against STDs.<ref name="vanhowe1999">{{REFjournal |last=Van Howe |first=Robert S. |init=RS |author-link=Robert S. Van Howe |etal=no |title=Does circumcision influence sexually transmitted diseases?: A literature review |journal=BJU Int |location= |date=1999 |volume=83 |issue=Suppl. 1 |pages=52-62 |url=https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1464-410x.1999.0830s1052.x |quote= |pubmedID=10349415 |pubmedCID= |DOI=10.1046/j.1464-410x.1999.0830s1052.x |accessdate=2020-03-31}}</ref> == Myth: protection against penile cancer ==Wolbarst was solely responsible for the invention of the myth that [[circumcision]] rendered males immune to [[penile cancer]]. Wolbarst (1926) made his claim for the first time that male circumcision prevents penile cancer.<ref name="wolbarst1926!>{{REFjournal |last=Wolbarst |first=Abraham L. |init=AL |title=Is circumcision a prophylactic against penis cancer? |journal=Cancer |date=1926-07 |volume=3 |issue=4 |pages=301-10}}</ref> Wolbarst (1932) put forward his claim that [[circumcision]] would prevent [[penile cancer]] in the British jounal, ''The Lancet''.<ref name="Wolbarst 1932">{{Wolbarst1932}}</ref> Wolbarst wrote an article that was published in ''The Lancet'' in 1932, implicating human male smegma as carcinogenic.<ref name="Wolbarst 1932"/> Wolbarst's myth was based entirely on unverifiable anecdotes, ethnocentric stereotypes, a faulty understanding of human anatomy and physiology, a misunderstanding of the distinction between association and cause, and an unbridled missionary zeal, and it had absolutely no basis in valid scientific and epidemiological research.<ref name="Fleiss 1996">{{REFjournal |last=Fleiss |init=PM |author-link=Paul M. Fleiss |last2=Hodges |init2=FM |author2-link=Frederick M. Hodges |title=[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2350473/pdf/bmj00534-0065d.pdf Neonatal circumcision does not protect against cancer] |journal=BMJ |date=1996 |volume=312 |issue=7033 |pages=779-80}}</ref> Wolbarst was directly responsible for its proliferation. All subsequent repetions of this myth are directly traceable to Wolbarst's article, though Wolbarst himself advocated universal neonatal circumcision principally as a preventive for epilepsy, paralysis, and [[masturbation]]. Circumcision advocates such as Wolbarst do not seem to have promoted this myth because they have a genuine interest in reducing penile cancer; they used it instead as a scare tactic in the promotion of neonatal circumcision.<ref name="Fleiss 1996"/> Wolbarst's false claims were not disproved until 1979. Boczko & Stanley (1979) collected numerous cases of cancer in [[circumcised]] men.<ref name="boczko1979">{{REFjournal |last=Boczko |first=Stanley |init=S |last2=Freed |first2=Selwyn |init2=S |title= Penile carcinoma in circumcised males |journal=N Y State J Med |date=1979-11 |volume=79 |issue=12 |pages=1903-04 |url=http://www.cirp.org/library/disease/cancer/boczko/ |pubmedID=292845 |accessdate=2020-04-02}}</ref> Epidemiological studies disproved Wolbarst's myth myths long ago. In North America the rate of penile cancer has been estimated to be 1 in 100,000.<ref>Cutler SJ, Young JL Jr. ''{{REFdocument |title=Third national cancer survey: incidence data''. Bethesda |url= |contribution= |last=Cutler S.J., MdYoung J.L. Jr. |first= |publisher=US Dept of Health, Education, and Welfare, Public Health Service |location=Bethesda, Md. |format= |date=1975 |accessdate=}}</ref>. Maden ''et al'' (1993) reported [[penile cancer ]] among a fifth of elderly patients from rural areas who had been [[circumcised ]] neonatally and had been born at a time when the rate of neonatal [[circumcision ]] was about 20% in rural populations.<ref>{{REFjournal |last=Maden |init=C, |last2=Sherman |init2=KJ, |last3=Beckman |init3=AM, |last4=Hislop |init4=TG, |last5=Teh |init5=CZ, |last6=Ashley |init6=RL, ''et al''. |etal=yes |title=History of circumcision, medical conditions, and sexual activity and risk of penile cancer. '' |journal=JNCI'' |date=1993; |volume=85: |pages=19-24}}</ref> Their study also shows that the rate of [[penile cancer ]] among men circumcised neonatally has risen in the [[United States ]] relative to the rise in the rate of neonatal [[circumcision]]. Although Wolbarst's falsehoods were disproved decades ago, they had entered into the American psyche where they continue to exert influence that they do not deserve.<ref name="hill2000">{{REFjournal |last=Hill |first=George |init=G |author-link=George Hill |etal=no |title=The Ghosts of Abraham Wolbarst and Aaron Fink |journal=BMJ |location= |date=2000-06-22 |volume= |issue= |pages= |url=https://www.bmj.com/rapid-response/2011/10/28/ghosts-abraham-wolbarst-and-aaron-fink |quote= |pubmedID= |pubmedCID= |DOI=https://doi.org/10.1136/bmj.320.7249.1592 |accessdate=2020-03-31}}</ref>

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